The National Cancer institute has developed explicit guidelines for cancer screening of asymptomatic populations to promote early detection and improved treatment outcomes. Various organizations, including the applicant, have made progress in applying computers to support cancer screening, especially for generation of annual reminder letters and scheduling of routine follow-up activities. However, the increased number of women with abnormal screening findings has taxed the resources available for timely clinical follow-up, particularly for low-income and medically underserved populations. Rosen Associates will build on its experience with tracking and follow-up systems for cancer screening by developing a computer software package that will provide reliable patient tracking to help screening and diagnostic clinics insure consistent levels of compliance with clinical follow-up recommendations and increase the proportion of cases with abnormal findings that are diagnostically resolved promptly. Phase I produced an operational prototype and defined areas for enhancement, including tailoring patient communications based on personal characteristics, providing clinic personnel with simple customization tools, and linking the system with existing patient databases. For Phase II, Rosen Associates will enhance, test, and evaluate the software at several clinic sites. The ultimate goal is packaging the software as a highly customizable commercial product.